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| Dr. Ilene Yohay |
The Continuous Glucose Monitoring System (CGMS) presents an innovative approach to help control blood sugar levels in diabetics. The system consists of a tiny sensor wire that is inserted just underneath the skin of the abdomen. The sensor measures glucose levels in the tissue at regular intervals and a transmitter on the skin above the sensor sends the information to a cell-phone-sized monitor that is worn on the waist.
Information including insulin taken, exercise, meals or snacks, and other events are also recorded for later review. The ability to review blood sugar data daily enables people to literally see how various foods they eat or exercise they engage in affects their blood sugars. This comprehensive monitoring is most beneficial to patients whose diabetes is not well controlled, and who experience frequent hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar levels). Another key benefit is the monitor’s ability to alert patients when they are approaching dangerous levels.
Patients calibrate the monitors periodically by entering finger stick blood sugar readings into the monitor. It’s important to note that the monitors do not replace standard finger stick blood sugar readings. However, they usually significantly reduce their frequency.
Capturing dangerously low overnight blood sugar levels, morning spikes, high between meal levels and more, this continuous monitoring provides physicians with a more effective and safe treatment approach. Alerts can be programmed into the monitor based on a doctor’s assessment of appropriate blood sugar levels, and can be adjusted as needed. Hypoglycemia can be dangerous, and with the CGMS, low blood sugars can be prevented before they occur. For example, if a sleeping patient’s glucose level reaches a point that indicates a steep drop may be in progress, an alarm will wake the patient.
In treating diabetes, we encourage good control because with better control there are fewer complications. However, with better control, patients also run the risk of hyperglycemia. The Continuous Glucose Monitoring System presents physicians with a tool that enables us to be aggressive about controlling blood sugars without the dangers.
The level of protection provided by these devices also gives parents of diabetic children an extra sense of security. When a child is acting out, for instance, it can be difficult to know if low blood sugar may be the culprit. A monitor showing two arrows pointing downward indicates a rapid drop in blood sugar. In this way, parents may be able to prevent certain behavior issues as well as other problems including seizures.
In order to bring this revolutionary device to the south suburbs, St. James Diabetes Center has started a program for the CGMS. At the Center, we can print out data from the monitor and review it with patients to give them a prospective and retrospective view on their blood sugars. Over a week’s time, we have seen blood sugars improving as patients get a better sense of what’s going on with their body and make more appropriate decisions.
For some patients, the Diabetes Center uses the sensor on a periodic basis for diagnostic purposes. Patients with a doctor’s prescription may also come to the Center to use the sensor on a trial basis to see if they might like to buy it, both of which are often covered by insurance.
Franciscan St. James Diabetes Center is a community resource for doctors and their patients. Anyone is welcome to make an appointment to learn more about the CGMS or for general diabetes education. The Center staffs endocrinologists, certified diabetes educators, dieticians and diabetes nurses.
Ilene Yohay, M.D. is an Endocrinologist at the St. James Diabetes Center. Franciscan St. James Health is a member of the Southland Health Alliance.
